CN102711677B - Bioresorbable vascular implant having homogenously distributed stresses under a radial load - Google Patents

Bioresorbable vascular implant having homogenously distributed stresses under a radial load Download PDF

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Publication number
CN102711677B
CN102711677B CN201080045203.2A CN201080045203A CN102711677B CN 102711677 B CN102711677 B CN 102711677B CN 201080045203 A CN201080045203 A CN 201080045203A CN 102711677 B CN102711677 B CN 102711677B
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vascular implant
resorbent
biology
support bar
hinged region
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CN102711677A (en
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马歇尔·范德里斯特
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Sahajanand Medical Technologies Pvt Ltd
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Arterial Remodeling Technologies SA
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    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • A61F2/915Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes with bands having a meander structure, adjacent bands being connected to each other
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2/00Filters implantable into blood vessels; Prostheses, i.e. artificial substitutes or replacements for parts of the body; Appliances for connecting them with the body; Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/82Devices providing patency to, or preventing collapsing of, tubular structures of the body, e.g. stents
    • A61F2/86Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure
    • A61F2/90Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure
    • A61F2/91Stents in a form characterised by the wire-like elements; Stents in the form characterised by a net-like or mesh-like structure characterised by a net-like or mesh-like structure made from perforated sheet material or tubes, e.g. perforated by laser cuts or etched holes
    • AHUMAN NECESSITIES
    • A61MEDICAL OR VETERINARY SCIENCE; HYGIENE
    • A61FFILTERS IMPLANTABLE INTO BLOOD VESSELS; PROSTHESES; DEVICES PROVIDING PATENCY TO, OR PREVENTING COLLAPSING OF, TUBULAR STRUCTURES OF THE BODY, e.g. STENTS; ORTHOPAEDIC, NURSING OR CONTRACEPTIVE DEVICES; FOMENTATION; TREATMENT OR PROTECTION OF EYES OR EARS; BANDAGES, DRESSINGS OR ABSORBENT PADS; FIRST-AID KITS
    • A61F2210/00Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof
    • A61F2210/0004Particular material properties of prostheses classified in groups A61F2/00 - A61F2/26 or A61F2/82 or A61F9/00 or A61F11/00 or subgroups thereof bioabsorbable

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  • Health & Medical Sciences (AREA)
  • Engineering & Computer Science (AREA)
  • Biomedical Technology (AREA)
  • Heart & Thoracic Surgery (AREA)
  • Life Sciences & Earth Sciences (AREA)
  • Cardiology (AREA)
  • Oral & Maxillofacial Surgery (AREA)
  • Transplantation (AREA)
  • Physics & Mathematics (AREA)
  • Vascular Medicine (AREA)
  • Optics & Photonics (AREA)
  • Animal Behavior & Ethology (AREA)
  • General Health & Medical Sciences (AREA)
  • Public Health (AREA)
  • Veterinary Medicine (AREA)
  • Prostheses (AREA)
  • Materials For Medical Uses (AREA)
  • Media Introduction/Drainage Providing Device (AREA)

Abstract

A bioresorbable vascular implant for implantation in a bodily lumen has a tubular framework and includes one or more annular support members. Each of the one or more annular support members includes a plurality of struts interconnected by a hinge region. Each of the plurality of struts also includes a mid-section. The vascular implant also includes at least one viscoelastic material that enables transition of the vascular implant between a collapsed configuration and an expanded configuration. Each of the plurality of struts and the hinge region defines a cross-section. The moment of inertia increases from the mid-section towards the hinge region to accommodate the transition and resist a radial load applied to the vascular implant in the expanded configuration.

Description

The biology under radial load with equally distributed stress can resorbent Vascular implant
Related application
This application claims the U.S. Provisional Patent Application No.61/249 submitted on October 6th, 2009, the priority of 010, the subject content of described temporary patent application is incorporated by reference at this.
Technical field
Generally speaking, the present invention relates to the implantable vessel device for Clinical intervention or vascular surgery, more particularly, relate in subside and all show the biology of homogeneous state of stress distribution under expanding two kinds of configurations can resorbent polymer shelf.
Background of invention
Clinical intervention and surgical technic and science, to be treated internal flaw and disease to reduce in the tissue injury for the treatment of around site using, obtain continual progress than otch less in the past or entered by the opening of vascular system or health.An importance of this kind for the treatment of relates at given treatment site (or multiple site) place's percutaneous placing rack or shelf (scaffold).
Support typically imports in blood vessel with collapsed configuration, then expands when being placed in blood vessel, to maintain unobstructed blood vessel.The expansion of support is based on memory (i.e. self expandable), based on distortion (i.e. air bag expansion) or both combinations.Use the support expanded of technology based on distortion, comprise in predetermined areas concentrated stress with the region of controlling distortion.Such as, the support of balloon expandable can have high stress areas in articulated section, so that controlled curling and expansion subsequently.
But, as the result of this structure, when applied, such as under expansion state under the radial load coming from blood vessel or health opening, stress is the highest in that region.When polymer support or shelf (scaffold), these region of stress concentrations may experience distortion due to the viscoelasticity property of polymeric material, thus cause the effect (namely support subsides or bounces back) do not wanted and be harmful to support.
Summary of the invention
According to an aspect of the present invention, the tubular frame comprising one or more annular brace elements can be had by resorbent Vascular implant for implantation into endoceliac biology.Each in one or more annular brace element comprises the multiple support bars interconnected by hinged region.Each in multiple support bar also has stage casing.Vascular implant comprises at least one viscoelastic material that Vascular implant can be made to change between collapsed configuration and expanded configuration.Each and hinged region in multiple support bar defines cross section.From stage casing towards hinged region, rotary inertia increases, to adapt to change and to resist the radial load being applied to the Vascular implant be under expanded configuration.
Accompanying drawing is sketched
For the professional of technical field involved in the present invention, after the description below reading with reference to accompanying drawing, above and other feature of the present invention will become obvious, in the drawing:
Under Figure 1A is showing and is in expanded configuration and can the schematic diagram of resorbent Vascular implant according to the biology of one aspect of the present invention structure;
Figure 1B is showing the schematic diagram of the amplifier section of the Vascular implant (Figure 1A) be under collapsed configuration;
Fig. 2 A is showing the schematic diagram of a part for the Vascular implant in Figure 1A;
Fig. 2 B is showing the schematic diagram of the amplifier section (dotted rectangle) of the Vascular implant in Fig. 2 A;
Fig. 2 C is showing the schematic diagram of the amplifier section (dashed circle) of the Vascular implant in Fig. 2 A;
Fig. 2 D is the cross-sectional view obtained along the line 2D-2D in Fig. 2 C;
Fig. 2 E is the cross-sectional view obtained along the line 2E-2E in Fig. 2 C;
Fig. 3 A is showing the schematic diagram of the enlarged side view of the hinged region of the Vascular implant in Figure 1A;
Fig. 3 B is showing the schematic diagram of the load (arrow) of the hinged region part put in Fig. 3 A;
Fig. 3 C is showing the schematic diagram of the free body figure of the hinged region in Fig. 3 B;
Fig. 4 A is showing the schematic diagram of the conventional shelf with taper hinged region;
Fig. 4 B is showing the schematic diagram of the enlarged side view of the hinged region of the shelf in Fig. 4 A;
Fig. 4 C is showing the schematic diagram of the load (arrow) of the hinged region part put in Fig. 4 B;
Fig. 4 D is showing the schematic diagram of the free body figure of the hinged region in Fig. 4 C;
Fig. 5 A is showing the schematic diagram of the conventional shelf of the another kind with the equal hinged region of cross sectional dimensions and support bar stage casing;
Fig. 5 B is showing the schematic diagram of the enlarged side view of the hinged region of the shelf in Fig. 5 A;
Fig. 5 C is showing the schematic diagram of the load (arrow) of the hinged region part put in Fig. 5 B;
Fig. 5 D is showing the schematic diagram of the free body figure of the hinged region in Fig. 5 C;
Fig. 6 be the stress of Vascular implant in Figure 1A-B to the curve of strain, therefrom can read maximum stress and yield stress.Support is immersed in the water of 37 DEG C, after the 2 minutes, uses the radial tester RCM-60-WB coming from MPT Europe company (Mulderspark 9-1,9351 NR Leek, Holland) to carry out radial compression in three consecutive periods.In one-period (curve A), the diameter producing 15% reduces.In second period (curve B), then produce the diameter reduction of 15%.In second period (curve C), the diameter of support is decreased to 1.7mm.As appears, after one-period, support turns back to its initial diameter, and after second period, support plastic deformation;
Fig. 7 A-B is a series of OCT images, and showing biology of the present invention can ideally resist with arterial wall by resorbent Vascular implant, and to which providing obvious radial support;
Fig. 8 is the photo amplified, and the biology shown in Fig. 7 A-B can implanted in Sanguis sus domestica guard system after 30 days by resorbent Vascular implant, the fracture of its cross support bar; And
Fig. 9 A-B is a series of pathology slide glasses, and the biology shown in Fig. 7 A-B can implant the good biocompatibility in Sanguis sus domestica guard system after 30 days by resorbent Vascular implant.
Describe in detail
Unless otherwise defined, otherwise all technical terms used in this article, there is the identical meaning usually understood with the ordinary skill of the technical field of the invention.
In text of the present invention, term " object " can refer to any warm-blooded organism, includes but not limited to the mankind, pig, rat, mice, Canis familiaris L., goat, sheep, horse, monkey, ape, rabbit, cattle etc.
As use alpha nerein, term " biology can resorbent polymer " can refer to that its degradation by-products can by the natural way in subject's body by polymer that is bio assimilated or excretion.
As use alpha nerein, term " curling " can reference and apply radial pressure reduce to make the diameter of Vascular implant on Vascular implant, and does not substantially affect the process of the structural constituent (such as wall or support bar) of Vascular implant.
As use alpha nerein, term " degradable polymer " can refer to when be placed in subject or aqueous solution and maintain under the condition such as temperature, osmolality, pH of simulation Physiological Medium time be degraded to the polymer of monomer and oligomer, described degraded does not preferably relate to enzymatic degradation, to be down to minimum by the risk of triggered target Ag-Ab system of defense.
As use alpha nerein, term " final reservation shape and diameter " can refer to the aimed dia of the Vascular implant launched in body cavity, length, design and wall thickness.
As use alpha nerein, term " negative retraction " can refer to the undesired reduction of the diameter of the Vascular implant expanded.
As use alpha nerein, term " just bounces back " and can refer to be manufactured with required final diameter but the increase being not yet fully expanded to the diameter of the Vascular implant of required final diameter.
As use alpha nerein, term " glass transition temperature " and " Tg " can refer to polymer be transformed from a glassy to rubbery state or in contrast time temperature.
As use alpha nerein, term " to lax relevant retraction " can refer to the known behavior according to viscoelastic polymer material, the slow change of the Vascular implant size that the time dependence due to molecular configuration is slowly reset and caused.Such rearranged portions is due to permanent static state or dynamic load, and it causes the polymeric material forming Vascular implant to reach thermodynamical equilibrium lentamente.
Generally speaking, the present invention relates to the implantable vessel device for Clinical intervention or vascular surgery, more particularly, relate in subside and all show the biology of homogeneous state of stress distribution under expanding two kinds of configurations can resorbent polymer shelf or support.As the representative of a kind of situation of the present invention, Figure 1A-B shows can resorbent Vascular implant 10 for implantation into the endoceliac biology comprising one or more annular brace element 12.Described one or more annular brace element 12 comprises multiple support bar 14, and it is each comprises stage casing 16 and hinged region 18.From comprise predetermined high stress areas (such as in hinged place) prior art can balloon expandable Vascular implant (such as support) different, Vascular implant 10 of the present invention being under expanded configuration and dynamic loading conditions (such as when expanding in body cavity, curling period or in the body cavity of pulsing time), show the radial resistance of raising.Radial resistance is improved to avoid the creep that caused by high frequency radial load by the maximum stress that spreads and limit appearance.As a result, from the stage casing 16 of support bar 14 to maximum torque region, distortion more uniformly distribution or absorb.
I. biology can resorbent Vascular implant
One aspect of the present invention comprises biology can resorbent Vascular implant 10, and it comprises one or more annular brace element 12.Vascular implant 10 can comprise the framework with tubulose substantially also can be implanted to endoceliac any element, device or utensil.Just as described in more detail below, Vascular implant 10 comprises at least one viscoelastic material that Vascular implant can be made to change between collapsed configuration and expanded configuration.
In an example of the present invention, Vascular implant 10 can comprise shelf (scaffold).The limiting examples of shelf (scaffold) can comprise support component, can collapsed member, expansible element, inflatable element, rigid structure, mesh structure, net device, loose structure, support bar, film, air bag, umbrella shape device, timber, spoke, framework and combination thereof.Shelf (scaffold) can be completely covered, part covers or do not cover.Capped shelf can comprise with film, fabric, thin film, multiple layer segment or the skeleton covering and/or wrap quilt completely.
In another example of the present invention, shelf (scaffold) can comprise support.
As shown in fig. 1, Vascular implant 10 comprises one or more annular brace element 12.When Vascular implant 10 comprises two annular brace elements 12, at least one cross support bar 20 can with annular brace elements intersect.At least one cross support bar 20 described can be made up of the viscoelastic material identical or different with one or more annular brace element 12.At least one cross support bar 20 described can to have compared with the degraded of one or more annular brace element 12 or absorbance more slowly, faster or identical degraded or absorbance.Such as, at least one cross support bar 20 described can to have about 90 days or more sky, the degraded in about 60 days or about 30 days or less skies or absorbance.
Vascular implant 10 can comprise any amount of cross support bar 20.Such as, when being implanted in bending vascular system, there is better flexible Vascular implant 10 in order to provide, may wish to comprise less cross support bar 20, so that Vascular implant can be adapted to the shape of vascular system after cross support bar degraded within a short period of time (such as decomposing or fracture) or absorption.Should be realized that, comprise cross support bar 20 and still omit them as a part for Vascular implant 10, the embody rule intending to use Vascular implant will be depended on, and degraded or the time span absorbed, depend on the quantity for the formation of the material rate of cross support bar, the shape of cross section of cross support bar, the anatomy of vascular system and cross support bar.In addition, should be realized that, cross support bar 20 can have any applicable size and dimension outside the rodding structure shown in Fig. 2 A-C.
Each passage 26(Figure 1A comprising the first end 22, second end 24 and extend between two ends in one or more annular brace element 12).As mentioned above, each (Fig. 2 A-C) in one or more annular brace element 12 also comprises the multiple support bars 14 interconnected by hinged region 18.Each and the hinged region 18 of described multiple support bar 14 defines cross section.Each support bar 14 can be rectangle, circle, ellipse, square or the shape needed for any other with the cross section of hinged region 18.
In an example of the present invention, each support bar 14(Fig. 2 A-E) comprise and define width W sstage casing 16, and each hinged region 18 defines width W h.As shown in Figure 2 A, first annular brace element 12 ' comprises V-arrangement support bar 14, second the annular brace element 12 of a series of repetitions be connected by hinged region 18 " comprise the V-arrangement support bar of a series of repetitions be also connected by hinged region.Should be realized that, depend on the intended application of Vascular implant 10, each support bar 14 comprising annular brace element 12 can have consistent or different structures (such as shape and size).
The each of annular brace element 12 comprises the multiple grids 28 defined by support bar 14 and hinged region 18.Grid 28 allows Vascular implant 10 to be curled into small diameter (i.e. collapsed configuration) from larger diameter (i.e. expanded configuration), and does not substantially change the structure of cross support bar 20 or annular brace element 12.Such grid 28 can be formed by the process technology of standard such as molded, cut, engraving or photoetch.Each annular brace element 12 can comprise the grid 28 of requirement.Such as, each annular brace element 12 can comprise about 4 to about 15 grids 28, is more preferably about 5 to about 6 grids.
With reference to figure 3A-C, the present invention can be understood best.As what see in Fig. 3 A-C, the width W at least partially of each support bar 14 sbe less than the width W of each hinged region 18 h.Such as, the width W in stage casing 16 scan be about 150 μm or more, the width W of hinged region 18 hit can be about 250 μm or more.In an example of the present invention, the width W at stage casing 16 place scan be about 160 μm, the width W at hinged region 18 place hit can be about 300 μm.
From hinged region 18 to the stage casing 16 of each support bar 14, width W hcan substantially reduce continuously.This effect reduced gradually is that rotary inertia is increased from stage casing 16 towards hinged region 18, puts under namely Vascular implant 10(be in expanded configuration to resist) radial load or its tangential source component.In other words, effect will be at hinged region 18 place (i.e. high bending moment place) higher deformation resistance, and it is more even that integrated stress is out of shape.Therefore, throughout being uniformly distributed of stress of one or more annular brace element 12, when ensure that when Vascular implant expansion and stand radial load subsequently, the tangential source radial strength of Vascular implant 10 and mechanical resistance are without prejudice.
The ideal of width reduces to be keep constant the driven complicated function of bending radius by effort.Such as, the flexure of rectangular beam is controlled by following formula:
1/R=12FL/(ETW 3);
Wherein R is the radius of curvature of hinged region 18, and F is the power applied, and L is distance from home, and E is Young's modulus, and T is the thickness of support bar 14, and W is support bar width.Therefore, as guilding principle, the width W of support bar should become along with the cubic root of the distance of an end apart from support bar 14.That is, at any some place in the stage casing 16 along support bar 14, width W is directly proportional to the cubic root of this point apart from the distance of an immediate end.But any of width W reduces gradually, even simply linearly reduce gradually, also still represent the remarkable improvement compared with constant width support bar.Because support bar 14 is wider at its hinged region 18 place, therefore whole Vascular implant 10 can deal with larger compression and expansionary force.Therefore, Vascular implant 10 can deal with larger fatigue stress, and this can produce more durable, more firmly Vascular implant.
Be down in minimum trial at the maximum stress experienced hinged region 18, present invention utilizes structural geometry, it stress distribution to support bar 14 will compare the not too responsive region (such as stage casing 16) of fracture with other regions.Such as, when the stent expands, one of the region of conventional bracket structure most fragile be inside hinged region on radius.In general these inner radial of hinged region are the regions this kind of supporting structure with most high stress level.
Fig. 4 A-D and Fig. 5 A-D respectively illustrates the example of conventional bracket structure 30 and 32.As shown in Fig. 4 A-D, some supporting structure 30 comprises taper connection district 34, its width W hbe less than the width W in the stage casing 36 of support bar 38 s.Such Framework construction is disadvantageous, this is because rotary inertia increases from hinged region 34 to stage casing 36, because this increasing the stress of hinged place after applying radial load.Similarly, as shown in Fig. 5 A-D, other conventional bracket structures 32 comprise and have equal wide W hand W shinged region 40 and support bar stage casing 42.Such Framework construction is disadvantageous, this is because rotary inertia keeps constant from hinged region 40 to stage casing 42 after applying radial load, thus creates uneven stress distribution on whole supporting structure 32.
Other examples of conventional bracket structure are disclosed in the U.S. Patent No. 6 of Duerig etc., 190,406, the U.S. Patent No. 7 of Roeder etc., 753,948(is called below " RoederI ") and the U.S. Patent Application No. 11/454,303(of Roeder etc. be called below " RoederII ") in.Duerig teach show equally distributed strain and by elastic material such as Nitinol make can the support of self expandable.Roeder I teach there is equally distributed stress can Self-expanded stent, it can to move in collapsed configuration and to be placed in and be maintained by support under collapsed mode for the sheath needed for endovascular delivery.Roeder I it is taught that support is made up of elasticity, non-resilient and elastic material (such as Nitinol), but does not instruct support to be made up of viscoelastic polymer.Roeder II teach can to hold a large amount of strain under collapsed mode and there is no a permanent damages can Self-expanded stent.Roeder II it is taught that support is made up of elasticity, non-resilient and elastic material (such as Nitinol), but does not instruct support to be made up of viscoelastic polymer.
As mentioned above, an advantage of the invention is that stress is more uniformly distributed on whole Vascular implant 10 after applying radial load.Specifically, stress level can be redistributed from hinged region 18, and along support bar 14 length, such as distribute near stage casing 16 place of each support bar or its.As a result, the maximum stress level at hinged region 18 place can be reduced.
Another advantage of the present invention is, by stress equilibrium being distributed in whole Vascular implant 10, can increase the fatigue life of Vascular implant.When using conventional stent designs, fatigue life may be a kind of misgivings, even if because after the implantation, support is still subject to the mild compression of arterial wall or other organizational structuries.Operational stresses induced is introduced in supporting structure by this compression.Because the heart of object typically causes a small amount of enlargement and contraction of the tremulous pulse in vascular system when each heartbeat, the support therefore implanted is general also a small amount of enlargement and contraction when each heartbeat.In the supporting structure of routine, because operational stresses induced circulation concentrates in hinged region, this may cause fatigue fracture in the hinged region of supporting structure.On the contrary, Vascular implant 10 of the present invention can be minimum by making operational stresses induced level be down to, and is reduced in risk that is bending or hinged place fracture.
All or part of of Vascular implant 10 can be formed from least one viscoelastic material.Viscoelastic material of the present invention can comprise any one or its combination in the material demonstrating viscosity and/or elastic characteristic when undergoing deformation.The feature of viscous behavior is when a stress, and Shear Flow and strain change linearly over time, and there is not the memory of original state.Elastomeric material strains at once when stretching, and is back to its initial condition equally rapidly after stress removes.Depend on temperature and rate of deformation, viscoelastic material can show viscosity and/or elastic behavior.When viscoelastic polymer, elasticity normally lacks the result (namely lower than glass transition temperature or under height distortion ratio, speed) of deformation time along the key of the crystallographic plane stretching in ordered solids or macromolecular structure, and viscosity is the result (higher than glass transition temperature, or under low distortion ratio, speed) of the motion of macromolecule fraction and/or macromole and/or macromole framework.When implantable polymeric device, stress-strain behavior depends on the position of glass transition relative to body temperature.Viscoelastic material for the formation of Vascular implant 10 of the present invention has the key element of these two kinds of character, therefore shows the strain of time dependence.
In an example of the present invention, Vascular implant 10 can be formed by any one viscoelastic material, such as degradable, biology in resorbent polymer (such as thermoplastic polymer) or its combination.Vascular implant 10 can be about 32 DEG C <Tg<100 DEG C by glass transition temperature (Tg), more specifically for the degradable of about 35 DEG C <Tg<68 DEG C and biology can be formed by resorbent polymer.Such as, Vascular implant 10 can be formed by resorbent polymer (such as thermoplastic polymer), because some material (such as steel) can at high temperature show certain viscoelasticity by one or more degradables and biology with low operating temperature range (such as Tg is about 37 DEG C).
Formed the polymer of Vascular implant 10 can be by one or more unbodied biologies can resorbent polymer, be not namely at room temperature the homopolymer that formed of the thin layer of polymer of crystal or copolymer.Remain for the formation of not producing crystal after the polymer degradation in vivo of Vascular implant 10, and can be cross-linked or not be cross-linked.Such as, if allow Vascular implant 10 domestication, curling and launch calorifics and viscoelasticity characteristic fully maintained, can photo-crosslinking be used.
The example of polymer that can be used for being formed Vascular implant 10 include but not limited to polylactic acid, polyglycolic acid, polycaprolactone and related copolymers thereof, Merlon, poe, condensing model, Ju diethyleno dioxide ketone and poly butyric ester, polyamide, polyurethane, polyureas, polyethers, polysaccharide, polyamide, polyamine, poly phosphate, polyphosphonates, polysulfonates, the copolymer of poly-sulfanilamide, polyphosphazene, polynorbornene and polynorbornene, poly-camphene with (thermoplastic elastomer (TPE)) and poly blend, styrenic block copolymer elastomer (such as styrene-butadiene), polymethyl methacrylate (PMMA), polyethylene, polyisoprene, polycaprolactone and polycaprolactone co-polymer, copolymer of poly lactic acid, co-glycolic acid, polydienes, nylon, polycyclic octene (PCO), polyvinyl acetate (PVAc), Kynoar (PVDF), the blend (PVAc/PVDF) of polyvinyl acetate/Kynoar, the blend (PVAc/PVDF/PMMA) of polymethyl methacrylate/polyvinyl acetate/Kynoar, polrvinyl chloride (PVC), their blend, derivant, copolymer and/or combination.
In an example of the present invention, Vascular implant 10 can be formed by following polymers: based on stereocopolymer (the PLAx copolymer be made up of L and D type unit of lactic acid, wherein X is the percent of L-lactyl units) (55<Tg<60), copolymer (the PLAxGAy of lactic acid and glycolic, wherein X is the percent of L-lactyl units, Y is the percent of glycolyl units, the Tg of copolymer is higher than about 45 DEG C), and lactic acid-ethanol-gluconic acid copolymer, wherein the OH base of glucose acyl unit more or less can be replaced (pLAxGayGLz, wherein X is the percent of L-lactyl units, Y is the percent of glycolyl units, Z is the percent of glucose acyl unit, make the Tg of ter-polymers higher than about 45 DEG C).
In another example of the present invention, Vascular implant 10 can be formed from the polylactic acid stereocopolymer produced by L-and DL lactic acid lactide.Described polymer is named as " PLAX " in this article, and wherein X represents the percent of Pfansteihl unit in the monomer mixture for the preparation of lactic acid lactide.X can in the scope of about 2 to about 98, such as about 20 to about 80.
In another example of the present invention, Vascular implant 10 can be formed from the polymer comprising polylactic acid and the ethanol copolymer produced by L and DL lactic acid lactide and glycollide.Polymer is named as in this article " PLAXGAY ", and wherein Y represents the percent of glycolic acid units in for the preparation of the monomer mixture of copolymer.Described copolymer does not contain glycolyl repetitive, since it is known such unit is more active than lactyl repeating units.Polymer can use metallic zinc or zinc lactate to prepare as initiator.In order to ensure the good initial mechanical properties of Vascular implant 10, the molecular weight of copolymer can higher than about 20,000 dalton, and such as about 100,000 dalton or larger.Polydispersity I=Mw/Mn, lower than about 2, and can greatly should not reflect that existence is less than about 2, the existence of the low-molecular weight oligo body of 000 dalton (when by when such as size exclusion chromatography measures).
II. biological can the domestication of resorbent Vascular implant and curling
Vascular implant 10 can be formed by standard technique, described technology is such as extruded, be molded, revolve spin, injection-molded, cut, they combination or viscoelastic polymer is transformed into any other process technology of the hollow devices with tubular frame.By any one in these methods or the Vascular implant 10 that is combined to form, can be configured to that there is the final predetermined configuration (such as shape, length, thickness, diameter) for the application of Vascular implant will be used to customize.Such as, Vascular implant 10 can be prefabricated into initial diameter, then heats under selected glass transition temperature or under higher temperature.Then curling for Vascular implant 10 (such as using mechanical means and/or cooling) can be become be suitable for being delivered to the profile that is less, that shrink in body cavity.Then Vascular implant 10 can be cooled, and be assembled into before implantation on guide catheter (not shown) or other delivery systems (such as air bag).Can be used for more discussing in detail of the method forming Vascular implant 10, be disclosed in PCT publication number WO 2005/096992 A1, its full content is incorporated by reference at this.
Vascular implant 10 can be manufactured into and carries and send various material or therapeutic agent, as long as these materials or medicament do not form solid solution with viscoelastic polymer, and does not play the effect of the plasticizer significantly changing implant function.Can by compressing or chemical coupling, by material or deposit medicament on the outer surface or inner surface of Vascular implant 10.Such material or medicament can comprise medicine, pharmaceutically active agents, medicine, genetic factor, non-genetic factor and cell.Various therapeutic agent widely can be used in the present invention, comprise the therapeutic agent being used for the treatment of various disease and disease widely (namely prevent disease or disease, alleviate or eliminate the symptom relevant to disease or disease or substantially or completely eliminate a disease or disease) such as cardiovascular disease and cancer.
III. determine that biology can the domestication of resorbent Vascular implant and curling time used and temperature program
Be applicable to tame Vascular implant 10, launch the temperature and time of the Vascular implant negative retraction to resistance thus, can by first assessing curling on balloon catheter for Vascular implant.Then make airbag inflation to start the expansion of Vascular implant 10.Removing air bag, and Vascular implant 10 is stored in about 37 DEG C.When storing, due to the just retraction character of Vascular implant, the diameter of Vascular implant 10 may increase.If shown seldom when Vascular implant 10 stores the time period (estimated time that such as arterial wall recovers from PTC angioplasty) in about 4 to 6 weeks under these conditions or negative retraction, then for taming time of Vascular implant 10 and temperature is applicable.When Vascular implant 10 shows a small amount of retraction, can by Vascular implant to tame, to compensate a small amount of negative retraction under the diameter being slightly greater than final predetermined diameter.
For by curling for Vascular implant 10 to swedged temperature and time, can by the Vascular implant being fixed on balloon catheter is placed in about under room temperature or storage temperature to get off assessment.If curling Vascular implant 10 keeps the minor diameter collapsed to corresponding to exhaust air-bag under these conditions, then the time used in curling period and temperature are applicable.By under final products being stored in the room temperature lower than about 20 DEG C, the optimization of the engineering properties (such as just bouncing back) that Vascular implant 10 is endowed can be realized.Such as, can by final products cold preservation at about 6 DEG C to about 8 DEG C.
IV. biological can the expansion of resorbent Vascular implant
After formation Vascular implant 10, Vascular implant can be implanted in body cavity and treat any one disease or disease (such as narrow or vulnerable plaque) or its combination.Can the body cavity of implantable intravascular implant 10 or the example of passage, comprise gastrointestinal tract (such as bile duct, colon, duodenum), esophagus, trachea-bronchial epithelial cell, urinary tract (such as urethra, prostate, ureter), pancreatic system, intestinal, eye pipe, deferent duct and fallopian tube and vascular system, such as artery and vein (such as femeroiliac tremulous pulse, carotid artery, Vertebral-basilar artery, renal artery, coronary vasodilator, peripheral blood vessel, intracranial vessel etc.).
Vascular implant 10 can be launched by various distinct methods.Such as, Vascular implant 10 can use such as guide catheter to import in body cavity or passage, then proceeds to endoceliac target site (such as narrow or vulnerable plaque site).The diameter of Vascular implant 10 and position can be determined by any method.Such as, can by part or all Vascular implant 10 with radiopaque material bag by or parcel, to allow Real Time Observation Vascular implant during implanting.An example of this radiopaque material can comprise gold, it does not stimulate, substantially not irritated, provide high cryptoscope visual when very thin layer, and it is believed that minimizing thrombosis.
In an example of the present invention, Vascular implant 10 can comprise the mark (not shown) of at least two configurations, can determine the diameter of Vascular implant according to them in real time.Mark can in a large number of ways in any one be applied on Vascular implant 10, be such as crimped onto the heavy metal coating of band on the support bar of Vascular implant and/or part sputtering.As will be described further below, mark may help to determine whether Vascular implant 10 is correctly expanded, and the diameter putting Vascular implant at any given time increases or reduces.
Be known in the art for detecting the imaging mode of mark, and X-ray, nuclear magnetic resonance (MRI) and ultrasonic imaging can be comprised.Mark can be used for the position of spike Vascular implant 10 when being moved by subject's body, and this greatly contributes to determining that the correct path whether Vascular implant passes through object moves.In addition, Vascular implant 10 is placed on endoceliac correct site by this help.
Should be realized that, Vascular implant 10 can comprise at least three marks alternatively.Use at least three marks any time during implanting can put the three-dimensional position determining Vascular implant 10.This feature guarantees that Vascular implant 10 does not have rotary motion in body cavity, and this rotary motion may occur when the external diameter of blood vessel diameter is less than the internal diameter of the body cavity placing Vascular implant.Vascular implant 10 is disadvantageous in endoceliac rotary motion, because it can increase blood flow turbidity, thus causes thrombosis.When rotary motion being detected during Vascular implant 10 is implanted, should be appreciated that and therefore the diameter of Vascular implant suitably should be increased.
After Vascular implant 10 is navigated to endoceliac target site place, Vascular implant can be made to expand into its final reservation shape.Vascular implant 10 can use any one or its combination in known technology to expand, such as, by the body heat of air bag, expansion fluid and/or object.Such as, Vascular implant 10 can use the combination of lasting air bag expansion and reminiscence (namely when reaching Tg selected by support) to expand, as in U.S. Patent Application Serial 12/282, disclosed in 738, this patent application is incorporated by reference in its entirety at this.
Vascular implant 10 slowly and continue, based on the just retraction of memory, stop or decrease the uncontrolled and excessive expansion that may cause the Vascular implant of damage to the tissue at target site place.In addition, the viscoelastic material due to Vascular implant 10 demonstrates time dependence strain, therefore Vascular implant slowly and the expansion continued avoids the crack and crackle of accompanying with the expansion of polymer shelf or support in typical case.Between expansionary phase and afterwards, the stress be evenly distributed on whole Vascular implant 10 guarantees that the radial strength of implant and mechanical resistance are without prejudice, thus stops or decrease the undesired of support or adverse influence (namely support subsides or bounces back).Therefore, the Vascular implant 10 of expansion not only shows radial rigidity to keep out elastic artery retraction, and by reducing stress or stoping stress to exceed yield stress to avoid crushing.
The following examples are only for purposes of illustration, are not intended for use the scope of the claims limiting appended hereto.
Embodiment
In 32 pigs every pig cardiovascular system in implant 2 biologies can resorbent support (as signal display in Figure 1A-2E), wherein 16 is family pig, and 16 is miniature pig.According to the code be applicable to, all stent deliveries are launched to its corresponding target site is also correct.28 days time, put to death family pig, 90 days time, put to death miniature pig.
After stenter to implant one month, the percentage rate of restenosis was lower than 50%, and the late luminal of wherein surveying on average is lost for about 0.6mm.As what can find out in Fig. 7 A-B, when 30 days and 90 days, support ideally resisted with arterial wall, thus provided obvious radial support.
In addition, some supports shifted out and processed by enzymic digestion flow process.The support reclaimed measures residual radial force.As shown in Figure 8, in a support reclaimed, connection fracture is confirmed.30 days time, radial force and rigidity do not reduce compared with the value before implantation.In addition, the good biocompatibility (Fig. 9 A-B) of support when histologic analysis confirms 30 days.Histologic analysis is by CBSET, and 500 Patriot Way, Lexington, MA 02421, USA performs.
According to description of the invention above, the professional of the art it is contemplated that out improvement, change and amendment.Such improvement, change and be modified in this area technical scope within, and be intended by the claims of enclosing and cover.

Claims (14)

1. biology can a resorbent Vascular implant, and it has tubular frame and for implantation in body cavity, described biology can comprise by resorbent Vascular implant:
One or more annular brace element, each of described one or more annular brace element comprises the multiple support bars interconnected by the hinged region with width, and each of described multiple support bar comprises the stage casing with width;
Wherein said Vascular implant comprises at least one viscoelastic material that described Vascular implant can be made to change between collapsed configuration and expanded configuration, and each and described hinged region of described multiple support bar defines cross section;
Wherein from described each stage casing towards described each hinged region, rotary inertia increases, to adapt to described transformation and to resist the radial load being applied to the Vascular implant be under expanded configuration;
The width of wherein said hinged region reduces from each described hinged region substantially continuously to each described stage casing;
Wherein when radial load is applied to the Vascular implant being in expanded configuration, the stress equilibrium ground distribution between the described stage casing of described multiple support bar and described hinged region.
2. the biology of claim 1 can resorbent Vascular implant, and wherein said Vascular implant is shelf.
3. the biology of claim 1 can resorbent Vascular implant, and wherein said Vascular implant is support.
4. the biology of claim 1 can resorbent Vascular implant, and wherein cross section defines width.
5. the biology of claim 4 can resorbent Vascular implant, and wherein width increases along with the applying of radial load.
6. the biology of claim 1 can resorbent Vascular implant, and it also comprises at least one the cross support bar with described one or more annular brace elements intersect.
7. the biology of claim 6 can resorbent Vascular implant, and each width of at least one cross support bar wherein said is less than the width of described hinged region.
8. the biology of claim 1 can resorbent Vascular implant, and the width of wherein said hinged region is greater than the width in described stage casing.
9. the biology of claim 6 can resorbent Vascular implant, and wherein after described Vascular implant is implanted in body cavity, at least one cross support bar described ruptures being less than in 90 days.
10. the biology of claim 1 can resorbent Vascular implant, and wherein said viscoelastic material comprises thermoplastic polymer.
The biology of 11. claim 10 can resorbent Vascular implant, and the glass transition temperature of wherein said thermoplastic polymer is at least 37 DEG C.
The biology of 12. claim 11 can resorbent Vascular implant, and wherein said thermoplastic polymer is polylactic acid polymer.
The biology of 13. claim 12 can resorbent Vascular implant, and wherein said polylactic acid polymer is PDLLA.
14. 1 kinds of biologies can resorbent Vascular implant, and it has tubular frame and for implantation in body cavity, described biology can comprise by resorbent Vascular implant:
One or more annular brace element, each of described one or more annular brace element comprises the multiple support bars interconnected by the hinged region with width, and each of described multiple support bar comprises the stage casing with width; And,
With at least one cross support bar of described one or more annular brace elements intersect;
Wherein said Vascular implant comprises at least one viscoelastic material that described Vascular implant can be made to change between collapsed configuration and expanded configuration, and each and described hinged region of described multiple support bar defines cross section;
Wherein from described each stage casing towards described each hinged region, rotary inertia increases, to adapt to described transformation and to resist the radial load being applied to the Vascular implant be under expanded configuration;
Wherein when radial load is applied to the Vascular implant being in expanded configuration, the stress equilibrium ground distribution between the described stage casing of described multiple support bar and described hinged region;
Wherein after described Vascular implant is implanted in body cavity, at least one cross support bar described be less than in 90 days rupture.
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